Singularity of Maternal Affectivity: vulnerability factors for mother-infant interaction in the interplay between mind, brain, and body

The quality of parenting that a child receives is one of the most important environmental factors influencing developmental outcomes. Thus, knowing vulnerability factors and related underlying mechanisms to adequate caregiving has fundamental clinical implications, informing effective preventive and intervention programs. Using a theoretical and empirical framework which acknowledges the complex and dynamic interplay between neurobiological, psychological, and behavioral processes, the present doctoral thesis aims to expand knowledge on variables which could contribute to explain inter-individual differences in observed parenting behaviors, with a specific focus on the role of emotion dysregulation as a vulnerability factor. Particularly, the presence of a lifetime history of two different disorders, which have been extensively related to impairments in diverse components of the emotional process, namely depression and somatization, will be used as doorways for exploring the impact of maternal affect dysregulation in originating at-risk developmental trajectories. More specifically, a life history of a disorder of affect regulation allows us to explore the role of trait-like rather than state-like emotion regulation difficulties. This aspect takes on particular relevance since the transition to motherhood is a period of increased vulnerability associated with high rates of onset or relapse of perinatal mental health disorders, while these kinds of vulnerability factors typically receive less attention in primary care contexts. Following this line of reasoning, Section I of this work is focused on maternal depression. Chapter 1 presents a longitudinal study aimed at investigating trajectories of change of neural response to infant stimuli in PFC areas across pregnancy and their contribution in explaining potential differences between mothers with and without a history of depression in the quality of parenting behaviors in the early postpartum. Section II focuses on maternal persistent somatization. First, since this is a widely unexplored topic in the literature, Chapter 2 describes a scoping systematic review which attempts to ascertain the impact of maternal persistent somatization on various aspects of parenting. Once clarified this aspect and relying on the findings and main limitations that emerged from this study, 6 Chapter 3 presents a two-wave exploratory study aimed at expanding the knowledge about the impact of a history of maternal somatization in the first year of life, while exploring the role of maternal individual variables, namely emotion dysregulation and coping styles. Finally, Section III is dedicated to a proposal for intervention. Chapter 4 presents the proof-of-concept and the implementation of an app-delivered support program aimed at promoting maternal intersubjectivity and sensitive caregiving based on some of the theoretical and empirical principles that we explored throughout this dissertation, as well as the study protocol of the work intended to take place to assess the usability of the smartphone application and preliminary effectiveness of the intervention. Beyond being the conclusive study of this thesis, it is intended as a starting point to be integrated with findings coming from the entire presented work. Overall, findings from the empirical studies show the significance of considering both general emotional competencies underlying early caregiving and disorder-specific impaired emotional processes, which could contribute to explaining inter-individual differences on observed parenting behaviors. Future research directions and clinical implications deriving from these results will be discussed.